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Conducts primary source verification for prospective providers and re-credentialing of active providers utilizing NCQA and other federal and state regulatory requirements. Resolves complex provider issues relating to credentialing, enrollment, privileging, billing and payers.
ExpandApply NowActive JobUpdated 3 months ago - UpvoteDownvoteShare Job
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Promptly meet payor requests for provider re-credentialing, revalidation, and re-verification. Work collaboratively with Revenue Cycle Director, Hospital Billing Manager, Professional Billing Manager, Hospital Billing Specialists, Professional Billing Specialists, Hospital Charge Entry Specialist, Financial Counselor, and Hospital and Professional Billing Representatives to identify and resolve provider credentialing issues that have potential to confound authorization or payment for patient services.
Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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The credentialing specialist will acquire primary source information necessary for DMC employment, as well as both initial and reappointment application or verification with all contracted health plans to ensure that all physician and non-physician provider requirements are met.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Responsible for provider oversight of the verification process of provider credentialing to ensure compliance with Community First Health Plans (CFHP) policies and procedures.
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The Credentialing Specialist is responsible for facilitating all aspects of provider credentialing, including initial appointment, reappointment, credential audits, as well as clinical privileging for Medical Staff, Allied Health Professionals, and all other providers as outlined in the corporate policy and procedures, or hospital bylaws.
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Assist Human Resources in provider onboarding as it relates to primary source verification, initial credentialing, the Licensing Specialist is the final reviewer of the provider/applicant's licensing and medical credentialing.
Full-timeExpandApply NowActive JobUpdated 22 days ago - UpvoteDownvoteShare Job
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Oversight of Council for Affordable Quality Healthcare (CAQH) and Credentialing Verification Organization (CVO) monthly invoices for all FFS, TERM and San Diego County Psychiatric Hospital (SDCPH) provider files.
Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Oversees the provider enrollment and credentialing process for the organization. Oversees and implements training in-services and developments for front desk staff on functional areas and their impact on revenue cycle performance measures, including cash collections, proper insurance verification and/or enrollment for patients with public and/or private insurance.
ExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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Ability to conduct efficient license verification, and credentialing compliance with NCQA protocol. Conduct background checks, license verification, and credentialing. Demonstrated experience in core functions of physician practice operations, including provider relations, patient flow, revenue cycle, quality, service excellence, purchasing and inventory, and teamwork, and accountability.
RemoteExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred or achievement of certification as determined appropriate by Greeley leadership.
Full-timeExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Maintains current provider profiles in the BMG Credentialing database SyMed OneApp. + Performs primary data source verification of new providers joining BMG. Performs initial development of Enrollment Portfolio for newly hired providers and assists in auditing established provider files.
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Track status of a carrier enrollments, update provider enrollment systems, and notify the appropriate EPIC Team, when necessary, as approval is obtainedWork with the other Professional Billing Office (PBO) departments, PCPO, the Partners Central Verification Office on any enrollment related issues that arise with the provider billingServe as a resource to providers, appointments coordinators, and PBO regarding the enrollment process.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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One Federal Solution is hiring an Administrative Specialist to support our Federal Government client in the Personal Identity Verification (PIV) card credentialing office in the Washingto,DC area.
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Certified Provider Credentialing Specialist (CPCS) preferred. Supervisor Credential Verification - Credential ServicesNorthridge Hospital Medical CenterWe are seeking a highly motivated and detail-oriented Supervisor Credential Verification Specialist to join our team.
$31.94 - $46.31Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Require Certified Provider Credentialing Specialist (CPCS) certification; or must be eligible to sit for exam within three (3) years from date of hire. This includes overseeing, monitoring, and maintaining all activities in the credentialing process to ensure compliance with regulatory, legal and company requirements and standards.
ExpandApply NowActive JobUpdated 8 days ago
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